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Background <p>Non-invasive methods assessing subclinical atherosclerosis, such as carotid intima-media thickness (IMT) and carotid-femoral pulse wave velocity (cfPWV), are well-described in adults but less so in the paediatric population. Other techniques, such as aortic IMT, may be more appropriate in children. This study aimed to characterise age-related changes to arterial vasculature using best practice methodology for these measures.</p> Methods <p>This cross-sectional study involved 97 healthy volunteers aged 2 to 20 (mean age 11.2 years [SD 5.1]). Carotid and aortic IMT were measured using high-resolution ultrasound. A validated semi-automated cuff-based device was used to measure cfPWV.</p> Results <p>Aortic IMT showed a significant age-related increase of 9 μm per year [95% CI: 6, 12], <i>p</i> &lt; 0.0001) during childhood and adolescence, whilst carotid IMT was significantly associated with male sex (29 μm per year [95% CI: 11, 48], <i>p</i> = 0.002) during this period. cfPWV exhibited an age-related increase from nine years of age onwards (0.11 ms<sup>-1</sup> per year [95% CI: 0.06, 0.15], <i>p</i> &lt; 0.001).</p> Conclusions <p>Age-related changes in the arterial vasculature vary between sites and methodologies. During childhood, aortic IMT appears to be a more sensitive marker for early structural changes and should be prioritised over carotid IMT and cfPWV.</p> Impact <p><UnorderedList Mark="Bullet"> <ItemContent> <p>Understanding age-related changes in arterial vasculature via non-invasive measures is poorly described in childhood and adolescence.</p> </ItemContent> <ItemContent> <p>This study finds that the timing and magnitude of age-related changes vary across arterial beds and between non-invasive measures in the first two decades of life.</p> </ItemContent> <ItemContent> <p>Aortic intima-media thickness is a more age-appropriate measure of early structural changes in the young than the more widely used carotid intima-media thickness.</p> </ItemContent> <ItemContent> <p>Furthermore, carotid-femoral pulse wave velocity, a measure of aortic stiffness, is best evaluated in late childhood and adolescence and likely has little relevance in early childhood.</p> </ItemContent> </UnorderedList></p>

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A cross-sectional study of non-invasive markers of vascular health in children and adolescents

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2025年5月3日

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  • Reeja F. Nasir,
  • Tommy Y. Cai,
  • Alice Meroni,
  • Hasthi Dissanayake,
  • Adrienne Gordon,
  • David S. Celermajer,
  • Michael R. Skilton

摘要

Background

Non-invasive methods assessing subclinical atherosclerosis, such as carotid intima-media thickness (IMT) and carotid-femoral pulse wave velocity (cfPWV), are well-described in adults but less so in the paediatric population. Other techniques, such as aortic IMT, may be more appropriate in children. This study aimed to characterise age-related changes to arterial vasculature using best practice methodology for these measures.

Methods

This cross-sectional study involved 97 healthy volunteers aged 2 to 20 (mean age 11.2 years [SD 5.1]). Carotid and aortic IMT were measured using high-resolution ultrasound. A validated semi-automated cuff-based device was used to measure cfPWV.

Results

Aortic IMT showed a significant age-related increase of 9 μm per year [95% CI: 6, 12], p < 0.0001) during childhood and adolescence, whilst carotid IMT was significantly associated with male sex (29 μm per year [95% CI: 11, 48], p = 0.002) during this period. cfPWV exhibited an age-related increase from nine years of age onwards (0.11 ms-1 per year [95% CI: 0.06, 0.15], p < 0.001).

Conclusions

Age-related changes in the arterial vasculature vary between sites and methodologies. During childhood, aortic IMT appears to be a more sensitive marker for early structural changes and should be prioritised over carotid IMT and cfPWV.

Impact

Understanding age-related changes in arterial vasculature via non-invasive measures is poorly described in childhood and adolescence.

This study finds that the timing and magnitude of age-related changes vary across arterial beds and between non-invasive measures in the first two decades of life.

Aortic intima-media thickness is a more age-appropriate measure of early structural changes in the young than the more widely used carotid intima-media thickness.

Furthermore, carotid-femoral pulse wave velocity, a measure of aortic stiffness, is best evaluated in late childhood and adolescence and likely has little relevance in early childhood.